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- - CITY OF ORONO - BUILDING PERMIT APPLICATION <br /> Total-Fee: $ Date Received: l /.,- C Lj <br /> Date Approved: <br /> Entered By: '/CG <br /> Permit#: 10/4.Z <br /> ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED <br /> (See Check-off List Enclosed) <br /> THE APPLICANT IS: (circle one) 42111) or CONTRACTOR <br /> JOB SITE ADDRESS: -I 1O OW LaMG LA-KesRDI ORO(W ZIP: 5E311 <br /> (work) V73 -TM <br /> NAME OF OWNER: Bata- )r D+`1 vN zhc LARI PHONE: (home) 973-ply <br /> MAILING ADDRESS: 9d10 OU) LOA CA\Cf RD CITY: 0P.OW0 ZIP: 55361 � . <br /> CONTRACTOR: Roc6FRICK, PHONE: 120 "~ 330(0 <br /> MAILING ADDRESS: ,152- t L/61 AW Pr AVE 50 CITY: Atpt6 ZIP: 55i4e, <br /> STATE LICENSE: # 1j2"1 <br /> ARCHITECT/ENGINEER: PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION # <br /> TYPE OF WORK: New Addition Accessory Structure X Move <br /> Demo Remodel/Alteration Renovate Land Alteration <br /> PROPOSED WORK (describe in detail) : COAJ I UC 7 A///N [Pun77M/ of A <br /> 2�f x ' Posy 6( E Hvucf FOR PFsOAJI-L. (A6F <br /> STORIES: ( SQ. FEET OF EACH FLOOR: 10542 42- <br /> NO. <br /> OF BEDROOMS: GARAGE STALLS: ATT. — DET. -- <br /> ESTIMATED <br /> ET. 'ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ (hVV <br /> I hereby apply for a building permit and I acknowledge that the information <br /> above is complete and accurate; that the work will be in conformance with the <br /> ordinances and codes of the City and with the State Building Code; that I <br /> understand this is not a permit and work is not to start without a permit; and <br /> that the work will be in accordance with the approved plan. <br /> .7- q4X1 <br /> APPLICANT'S SIGNATURE: DATE: <br />